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- Prognostic value of reduced heart rate reserve during exercise in hypertrophic cardiomyopathyPublication . Ciampi, Quirino; Olivotto, Iacopo; Peteiro, Jesus; D’Alfonso, Maria; Mori, Fabio; Tassetti, Luigi; Milazzo, Alessandra; Monserrat, Lorenzo; Fernandez, Xusto; Pálinkás, Attila; Pálinkás, Eszter; Sepp, Róbert; Re, Federica; Cortigiani, Lauro; Tesic, Milorad; Djordjevic-Dikic, Ana; Beleslin, Branko; Losi, Mariangela; Canciello, Grazia; Betocchi, Sandro; Lopes, Luis; Cruz, Ines; Cotrim, Carlos; Torres, Marco; Bellagamba, Clarissa; Van De Heyning, Caroline; Varga, Albert; Ágoston, Gergely; Villari, Bruno; Lorenzoni, Valentina; Carpeggiani, Clara; Picano, EugenioBackground: Sympathetic dysfunction can be evaluated by heart rate reserve (HRR) with exercise test. Objectives: To determine the value of HRR in predicting outcome of patients with hypertrophic cardiomyopathy (HCM). Methods: We enrolled 917 HCM patients (age = 49 +/- 15 years, 516 men) assessed with exercise stress echocardiography (ESE) in 11 centres. ESE modality was semi-supine bicycle in 51 patients (6%), upright bicycle in 476 (52%), and treadmill in 390 (42%). During ESE, we assessed left ventricular outflow tract obstruction (LVOTO), stress-induced new regional wall motion abnormalities (RWMA), and HRR (peak/rest heart rate, HR). By selection, all patients completed the follow-up. Mortality was the predetermined outcome measure Results: During ESE, RWMA occurred in 22 patients (2.4%) and LVOTO (>= 50 mmHg) in 281 (30.4%). HRR was 1.90 +/- 0.40 (lowest quartile <= 1.61, highest quartile > 2.13). Higher resting heart rate (odds ratio 1.027, 95% CI: 1.018-1.036, p < 0.001), older age (odds ratio 1.021, 95% CI: 1.009-1.033, p < 0.001), lower exercise tolerance (mets, odds ratio 0.761, 95% CI: 0.708-0.817, p < 0.001) and resting LVOTO (odds ratio 1.504, 95% CI: 1.043-2.170, p = 0.029) predicted a reduced HRR. During a median follow-up of 89 months (interquartile range: 36-145 months), 90 all-cause deaths occurred. At multivariable analysis, lowest quartile HRR (Hazard ratio 2.354, 95% CI 1.116-4.968 p = 0.025) and RWMA (Hazard ratio 3.279, 95% CI 1.441-7.461 p = 0.004) independently predicted death, in addition to age (Hazard ratio 1.064, 95% CI 1.043-1.085 p < 0.001) and maximal wall thickness (Hazard ratio 1.081, 95% CI 1.037-1.128, p < 0.001). Conclusions: A blunted HRR during ESE predicts survival independently of RWMA in HCM patients.
- Stress Echo 2030: the novel ABCDE-(FGLPR) protocol to define the future of imagingPublication . Picano, Eugenio; Ciampi, Quirino; Cortigiani, Lauro; Arruda-Olson, Adelaide M.; Borguezan-Daros, Clarissa; de Castro e Silva Pretto, José Luis; Cocchia, Rosangela; Bossone, Eduardo; Merli, Elisa; Kane, Garvan C.; Varga, Albert; Agoston, Gergely; Scali, Maria Chiara; Morrone, Doralisa; Simova, Iana; Samardjieva, Martina; Boshchenko, Alla; Ryabova, Tamara; Vrublevsky, Alexander; Palinkas, Attila; Palinkas, Eszter D.; Sepp, Robert; Torres, Marco A. R.; Villarraga, Hector R.; Preradović, Tamara Kovačević; Citro, Rodolfo; Amor, Miguel; Mosto, Hugo; Salamè, Michael; Leeson, Paul; Mangia, Cristina; Gaibazzi, Nicola; Tuttolomondo, Domenico; Prota, Costantina; Peteiro, Jesus; Van De Heyning, Caroline M.; D’Andrea, Antonello; Rigo, Fausto; Nikolic, Aleksandra; Ostojic, Miodrag; Lowenstein, Jorge; Arbucci, Rosina; Haber, Diego M. Lowenstein; Merlo, Pablo M.; Wierzbowska-Drabik, Karina; Kasprzak, Jaroslaw D.; Haberka, Maciej; Camarozano, Ana Cristina; Ratanasit, Nithima; Mori, Fabio; D’Alfonso, Maria Grazia; Tassetti, Luigi; Milazzo, Alessandra; Olivotto, Iacopo; Marchi, Alberto; Rodriguez-Zanella, Hugo; Zagatina, Angela; Padang, Ratnasari; Dekleva, Milica; Djordievic-Dikic, Ana; Boskovic, Nikola; Tesic, Milorad; Giga, Vojislav; Beleslin, Branko; Di Salvo, Giovanni; Lorenzoni, Valentina; Cameli, Matteo; Mandoli, Giulia Elena; Bombardini, Tonino; Caso, Pio; Celutkiene, Jelena; Barbieri, Andrea; Benfari, Giovanni; Bartolacelli, Ylenia; Malagoli, Alessandro; Bursi, Francesca; Mantovani, Francesca; Villari, Bruno; Russo, Antonello; De Nes, Michele; Carpeggiani, Clara; Monte, Ines; Re, Federica; Cotrim, Carlos; Bilardo, Giuseppe; Saad, Ariel K.; Karuzas, Arnas; Matuliauskas, Dovydas; Colonna, Paolo; Antonini-Canterin, Francesco; Pepi, Mauro; Pellikka, Patricia A.; The Stress Echo 2030 Study Group of the Italian Society of Echocardiography and Cardiovascular Imaging (SIECVI)With stress echo (SE) 2020 study, a new standard of practice in stress imaging was developed and disseminated: the ABCDE protocol for functional testing within and beyond CAD. ABCDE protocol was the fruit of SE 2020, and is the seed of SE 2030, which is articulated in 12 projects: 1-SE in coronary artery disease (SECAD); 2-SE in diastolic heart failure (SEDIA); 3-SE in hypertrophic cardiomyopathy (SEHCA); 4-SE post-chest radiotherapy and chemotherapy (SERA); 5-Artificial intelligence SE evaluation (AI-SEE); 6-Environmental stress echocardiography and air pollution (ESTER); 7-SE in repaired Tetralogy of Fallot (SETOF); 8-SE in post-COVID-19 (SECOV); 9: Recovery by stress echo of conventionally unfit donor good hearts (RESURGE); 10-SE for mitral ischemic regurgitation (SEMIR); 11-SE in valvular heart disease (SEVA); 12-SE for coronary vasospasm (SESPASM). The study aims to recruit in the next 5 years (2021–2025) ≥10,000 patients followed for ≥5 years (up to 2030) from ≥20 quality-controlled laboratories from ≥10 countries. In this COVID-19 era of sustainable health care delivery, SE2030 will provide the evidence to finally recommend SE as the optimal and versatile imaging modality for functional testing anywhere, any time, and in any patient.